“No way am I doing that treatment.” My husband, Michael, uttered those words through gritted teeth as he stumbled to our car after being fitted for his radiation mask. In over 20 years of marriage, I...

Not always, but too often, my patient and I both watch my right hand as it shakes. Sometimes, to finish writing a prescription, I steady it with my left hand. Oops. And I wonder: Should I address the...

A 27-year-old woman presented with a 2-month history of a lump around the umbilicus. Initially measuring 0.5 cm, the nodule gradually increased in size, with no relationship to position or her menstru...

Despite advancements in treatment and HIV viral suppression, people with HIV experience a risk of myocardial infarction that is 1.73 times higher than in people without HIV.[1][1] Believed to be in pa...

Key points A 39-year-old otherwise healthy man presented to the emergency department with severe rectal pain and a 3-day history of constipation. He had presented to another community emergency depart...

Background: The long-term impacts of traumatic brain injury (TBI) in older adults are not well known. Our objective was to describe the association between late-life TBI, incident dementia, and health...

The laboratory was quiet in the early morning light. Just as all peoples hold myths and every person a memory, perhaps even the smallest and quietest of things bears a history — buried, unnamed, but n...

Key points On Jan. 20, 2025, the incoming United States administration froze all foreign assistance funds for 90 days, including the President’s Emergency Plan for AIDS Relief (PEPFAR) funding.[1][1] ...

A 68-year-old man presented to the gastroenterology clinic with recurrent melena over 3 months with a history of recurrent spontaneous epistaxis and a familial pattern of similar bleeding among his fi...

Multiple sclerosis (MS) often begins in early adulthood, and symptoms may include fatigue, pain, and mood changes. These may not be outwardly visible but can be deeply disabling.[1][1] Clinicians shou...

More than 85 000 (2.3 per 1000) people in Canada have cerebral palsy, a group of disorders resulting from a nonprogressive brain lesion early in life. Seventy-five percent of those living with cerebra...

Background: Determining optimal timing for intensifying the frequency of physician encounters for type 2 diabetes mellitus (T2DM) requires trade-offs between timely care and clinician burden. We aimed...

My pager buzzed, its vibration cutting through the hum of another night on internal medicine call. The familiar number on the screen indicated ward 5. I dialled, and the charge nurse who answered reas...

Key points New evidence has led to a change in the way that some patients with amyotrophic lateral sclerosis (ALS) are classified and treated. Based on the findings of a landmark trial,[1][1] the drug...

A 73-year-old man on immunosuppressive therapy after renal transplantation presented to our emergency department with fever, weakness, nausea, and vomiting. Before transplantation, he was seropositive...

Key points A 62-year-old woman presented to the Adult Radiation Late Effects Clinic with a 3-year history of left-sided lower chest wall asymmetry, tightness, and pain. Twenty-seven years prior, at ag...

Background: Although rare in the general population, spinal bulbar muscular atrophy (SBMA) is an X-linked recessive neuromuscular condition that is highly prevalent in people identifying as First Nati...

Background: Whether virtual health care has changed access to services for patients living far from a specialist physician is unknown. We aimed to determine whether driving distances between patients ...

Background: Consent forms have become too long and often do little to help people understand the risk elements of their participation in research, instead focusing on risk reduction for research institutions. Under the auspices of the Canadian Institutes of Health Research and the Canadian Critical Care Trials Group, we identified a core set of elements for participant consent documents to be used in clinical research and present these as a template consent form. Methods: Our guideline core team comprised experts in the legal and ethical aspects of research, and a clinical trialist–scientist. We conducted a directed review to compile a list of applicable regulatory, policy, and guidance requirements for the documentation of informed consent for research conducted with human participants in Canada. We used a gap analysis to identify the elements required in a research consent form, based on these documents and in comparison with 10 existing research ethics board (REB) informed-consent form templates. The guideline, as well as a fillable template for the form, was created with input from a pan-Canadian advisory group, interested parties, and broad public input. We tested the template with a small group of studies across several research domains. Our process for managing competing interests adhered to Guidelines International Network principles. Recommendations: From our gap analysis, we identified 75 core elements for participant consent forms in clinical research, which we have grouped under 6 main categories (i.e., information for potential participants about participating in research in general and in the particular study; harms and benefits of participation; protection of participant data; points of contact; and giving consent) in a fillable consent template. Because studies vary, specific elements should be included in a study consent form only if relevant to the type of research being conducted and the corresponding compliance requirements, as identified in our gap analysis. Interpretation: The template with the core set of required elements is intended to be used by any researcher applying for REB approval to document participant consent and, when applied with consideration of our associated guidance, is sufficient to meet regulatory requirements for research in Canada. Identifying the required elements for consent forms is intended to streamline consent documents across the country, facilitate multi-site projects, and simplify the approval process for all those involved.

Key points The health implications of exposures to the Alberta oil sands are underresearched, despite more than a decade of calls from Indigenous communities and researchers for further investigation....